Wake at dawn with a winged heart and give thanks for another day of loving - Kahlil Gibran

NAMASTE AND WELCOME TO THE WAY UP FREE HEALTH NEWSLETTER TO WHICH YOU HAVE SUBSCRIBED

L-carnitine is an amino acid derived nutrient which is critical for life. It has the important job of converting fats from foods to energy in the body. L-Carnitine is obtained from eating meat and dairy products, predominantly red meat. It is can also be manufactured in the liver & kidneys from other precursor nutrients. These are the amino acids lysine & methionine. Adequate amounts of iron, vitamin B6, vitamin B3, and vitamin C and the enzymes which drive the conversion must also be present. A deficiency of any of these components can contribute to lower carnitine levels. The kidneys also work to conserve carnitine by balancing by the elimination & reabsorption of carnitine. Supplemental choline helps to maintain carnitine levels by reducing urinary excretion.

L-carnitine is found in most cells of the body, particularly the brain and other neural tissues, muscles, and heart. Though made in the liver & kidneys it must be transported to other tissues. It is most concentrated in tissues which use fatty acids as their primary dietary fuel, such as skeletal and cardiac (heart) muscle.

Deficiencies of carnitine can be caused by genetic & enzymatic disorders which interfere with the transportation or production of L-carnitine. Certain severe health problems, and inadequate dietary precursors as mentioned above can also lead to deficiency..

Genetic primary systemic carnitine deficiency is rare & can be life threatening. It is caused by underlying problems in natural synthesis or transport.

Screening in newborns for genetic primary carnitine deficiency has been included in an expanded newborn screening panel in some states. One thousand infants are born yearly with metabolic carnitine deficiency. Half die rapidly from being misdiagnosed. Lethargic infants with poor muscle tone and weakness should be suspected of carnitine deficiency. In certain genetic cases symptoms may not present until adulthood, while in others the onset is between 1-7 years of age.

Severe symptoms of significant carnitine deficiency can be:

Sudden death from primary systemic deficiency

Sudden death from secondary deficiency, which has caused heart rhythm disturbances such as ventricular tachycardia or fibrillation.

Cardomyapathy (heart muscle inflamed & not working well)

Heart failure

Pericardial Effusion (fluid accumulation around the heart which impairs function).

Hypoglycemic hypoketotic encephalopathy (a syndrome of global brain dysfunction) often accompanied by an enlarged liver & elevated blood ammonia and may be associated with seizures.

Episodes of decompensation which may be triggered by fasting or infection

Peripheral neuropathy

Elevated triglycerides & fatty infiltration of the liver and muscle.

Myoglobinuria (muscle protein lost in the urine caused by the destruction of muscle tissue)

Secondary carnitine deficiency is from a dietary lack, or from anything causing abnormal utilization or loss of carnitine. Most healthy adults with adequate intake of a good variety of foods will have sufficient carnitine levels.

The following circumstances may create a risk for deficiency symptoms or may require extra carnitine support:

There are 3 types of supplemental carnitine available, L-carnitine (LC), Acetyl-l-carnitine (AC), and Propionyl-l-carnitine (PLC). Carnitine is also available by prescription in both oral & IV forms. This is called Carnitor. It is provided as either 330 mg tablets or an oral solution providing 1,000 mg per 10 ml. It also comes in a sugar free liquid. For severe deficiencies the adult dose of Carnitor is 990 mg 2-3 x daily. The children’s dose is 50-100 mg/kg daily.

There has been a great deal of confusion about the three types of carnitine. The question most often asked is: Are they all the same and if not what is the difference? Although all three forms contribute to energy production by releasing energy from fat, they each have an affinity for different cells in your body. This enables them to provide their own specific health benefits.

The carnitines are absorbed into the bloodstream efficiently and are effective in carrying fatty acids across the membrane into the cell where fatty acids are burned as energy and utilized efficiently by the mitochondria (the energy producers of the cell). Mitochondria are specialized sub units within cells. Their main function is to generate energy from food molecules, but they are involved in several vital cell processes.

The main difference between the acetyl-L-carnitine (ALC) and L-carnitine (LC) is that ALC also contains an attached acetic acid group, which makes it superior to its non-acetylated cousin. Acetic Acid is an antibacterial and antifungal agent. Even though this structural difference is small, it produces a considerable difference in the biochemical properties of the molecule and in its effects on metabolism.

The body can convert L-carnitine to acetyl-L-carnitine and vice versa. It is not known whether the effects of acetyl-L-carnitine are from the chemical itself, from the L-carnitine it can make, or from some other chemical made along the way.

Because it has the ability to reduce oxidative stress, L-carnitine is used as part of the management of many conditions. If you have a medical condition, which could potentially benefit from the addition of carnitine, discuss with your doctor before taking carnitine. It is to be only used as adjunct not in place of your treatment from your doctor.

L-carnitine has been the most researched& available of the various forms of carnitine. Those studies have revealed the following.

Regulates heart function and enhances the stress tolerance of the heart.

Helps your body to oxidize amino acids to produce energy when needed

Helps metabolize ketones

Heart attack, Protects the heart from damage when a heart attack or a spasm cuts off the oxygen supply by reducing oxidative damage. In ischemic heart disease, carnitine levels are very low, either because of leakage from damaged tissue or the high rate of esterification. Carnitine has been used with some success in ischemic heart disease, congestive heart failure and arrhythmias."Carnitine and its role in cardiovascular disease, Heart Disease, 1999;1:108-113.

Ameliorates damage from impaired circulation. Carnitine and its derivative propionyl-L-carnitine are endogenous cofactors which enhance carbohydrate metabolism as well as reduce the intracellular build-up of toxic metabolites in ischemic conditions. Carnitine and its derivatives have been used for angina pectoris, acute myocardial infarction, postmyocardial infarction, congestive heart failure,peripheral vascular disease. "Carnitine and Its Derivatives in Cardiovascular Disease," Arsenian, Michael A

May protect against cardiac arrhythmias. "Carnitine administration after myocardial infarction may limit infarct size and protect against arrhythmias. In certain types of angina carnitine increases exercise tolerance and reduces ST segment depression. Carnitine supplementation has been shown to increase exercise tolerance in patients with intermittent claudication and it may protect against the cardiotoxic effects of the anthracycline group of anticancer chemotherapeutic agents. Though debatable, carnitine may be used to improve exercise performance in athletes."The Lancet, March 17, 1990;335:631-632.

Improves circulation,Intermittent Claudication in Peripheral Arterial Disease. It has shown benefit in intermittent claudication and has been found to enhance the absolute walking distance in this condition.

May help with erectile dysfunction. Testosterone and carnitine treatment significantly improved nocturnal penile tumescence, the International Index of Erectile Function score, Depression Melancholia Scale score, and fatigue scale score. Carnitine was significantly more active than testosterone in improving nocturnal penile tumescence and the International Index of Erectile Function score. Testosterone significantly increased prostate volume and free and total testosterone levels and significantly lowered serum luteinizing hormones, while the carnitine treatment did not. There was no effect on prostate-specific antigen or prolactin with either therapy. These therapies were beneficial as long as they were given. Only in the first group was the prostate volume significantly greater than baseline 6 months after the testosterone suspension. Acetyl-L-carnitine plus Propionyl-L-carnitine May Benefit the Treatment of Erectile Dysfunction. Dose usually ALC 2 grams daily plus PLC 2 grams daily

Helps with male infertility. Low sperm count and abnormal motility have been linked to low carnitine levels in men. Several studies have shown that L-carnitine helped increase sperm counts and motility. A systematic review of studies was undertaken to examine the effects of supplementation with L-carnitine (LC) and/or L-acetyl-carnitine (ALC) on male infertility. After identifying and reviewing 9 randomized controlled trials, meta-analysis found that compared to placebo, treatment with LC or LAC brought about significant improvements in pregnancy rate, total sperm motility, forward sperm motility, and atypical sperm cell, while no significant changes were found in sperm concentration and semen volume. These results suggest that supplementation with L-carnitine or L-acetyl-carnitine may improve pregnancy rates and sperm kinetic features in men with infertility. The authors conclude, "…The exact efficacy of carnitines on male infertility needs to be confirmed by further investigations." L-Carnitine and L-Acetyl-Carnitine May Be an Effective Treatment for Male Infertility.

May help with hair loss. "Our findings suggest that l-carnitine stimulates human scalp hair growth by up regulation of proliferation and down regulation of apoptosis in follicular keratinocytes in vitro. They further encourage one to explore topical and nutraceutical administration of l-carnitine as a well-tolerated, relatively safe adjuvant treatment in the management of androgenetic alopecia and other forms of hair loss.L-Carnitine May Stimulate Hair Growth

Dr Stephen T. Sinatra (M.D.), a board-certified and leading cardiologist, who has been using carnitines in his practice for 10 years, says: “Everybody on the planet should take some form of carnitine.”

Acetyl-l-carnitine is unique with respect to it’s effects on the brain. It more readily traverses the blood-brain barrier and is thought to be more readily absorbed and to be more bio-available to the central nervous system. ALC is considered a "pleiotropic agent capable of offering neuroprotective & possibly cognitive enhancing effects for neuro psychiatric disorders". ALC exhibits powerful antioxidant effects in the brain and helps to stabilize cell membranes. It affects various neurotransmitter systems in the brain such as the cholinergic, dopaminergic, NMDA Receptor systems.

In a review of studies from Jan. 1966-May 2007, Acetyl-l-carnitine was found to have antioxidant, anti-inflammatory & metabolic regulatory effects.

Studies have shown ALC may help to:

Reduce depression

Improve memory problems in elderly people and in people who use alcohol excessively. Studies have shown taking ALC seems to improve memory in 30-60 year-old people & in those who’s use of alcohol has produced long-term cognitive problems.

May help mental & physical fatigue in the elderly

Reduce nerve pain (neuropathy) caused by Type II Diabetes. Most useful for people who have been newly diagnosed or who have poorly controlled type 2 diabetes & who start using ALC early in the process. Also may decrease insulin resistance, reduce LDL oxidation & enhance lipid profiles

Treat Peyronie’s disease, a connective tissue disease in men related to abnormal carnitine of the penis. Useful in reducing the pain associated with this disease. Also helps to slow down the progression of the disease.

Slow the progression of Alzheimer’s disease. Acetyl-L-carnitine is more likely to help those with early-onset Alzheimer’s disease who are less than 66 years of age. Recently a multicenter trial giving acetyl-carnitine at 2 gms per day for 1 year affected the progression of cognitive and functional impairment in Alzheimer's disease. This was a placebo, double-blind trial. The 2 gm dose was well tolerated, except for some agitation such as restlessness and motor overactivity. Sixty-three patients in this study received acetyl-carnitine and 67 received placebo. Although intraindividual variability was high, the acetyl-carnitine group showed a consistently reduced rate of progression, which was statistically significant for the Blessed Dementia Scale and for the 3 neuropsychological tests. "Acetyl-Carnitine and Alzheimer's Disease",

Help prevent cataracts. Research conducted at the Medical College of Georgia has shown that acetyl L-carnitine (ALC) can be of significant value for the protection of ocular tissues, especially in diabetics. Diabetics and others who become susceptible to high levels of glucose in blood serum as they age suffer from the formation of deleterious hybrid protein-sugar complexes known as advanced glycation end products (AGE) otherwise known as cataracts. The results show that acetyl-L-carnitine suppresses glycation by 42%, and produced a 70% reduction in one measurement of Advanced Glycation End products (AGEs). It is the formation of AGEs that makes cataract irreversible.

Rat studies suggest ALC may exert anti-aging effects

Like the other forms, Glycine Propionyl L-Carnitine offers its own distinct health-related benefits. It is a derivative of carnitine which may have better bioavailability. PLC has primarily been researched for issues related to improving blood flow in the body, such as & peripheral vascular disease studies.

Studies have shown propionyl-l-carnitine benefits include:

Help in the recovery from heart attacks. Recent studies have shown that propionyl-L-carnitine works by protecting heart muscle cells from damage caused by lack of blood flow. Because it penetrates into heart muscle cells quickly, it is thought to be an advantage in supporting heart muscle recovery following a heart attack. Animal studies have demonstrated that PLC not only presents tissue damage related to lack of blood flow, but also has the ability to prevent any existing damage from getting worse.

Help with recovery from congestive heart failure. In a recent study, patients with congestive heart failure, who were given propionyl-L-carnitine each day for 15 days, experienced a 21% increase in exercise tolerance and a 45% increase in oxygen consumption.

Provide powerful support for peripheral arterial blood flow and is the form preferred in research on Peripheral arterial disease (PAD)

Increased nitric oxide production

Scientists have found that all of these carnitines combined have a remarkable synergistic effect that increases their therapeutic value.

Studies have shown that a combination of L-carnitine, acetyl-L-carnitine and Glycine Propionyl L-Carnitine significantly increases peak running speed and total workload in athletes compared to both placebo and individual carnitine. The combination formula is also much more effective in helping adults recover from physical, mental and emotional fatigue.

In general carnitine is well tolerated and safe. Toxic effects related to overdose have not been reported. There have been minimal side effects . Higher doses at one time may be overstimulating or cause nausea. Higher doses may rarely cause "fishy" breath or body odor.

The general supplemental dose is 1-4 grams daily in divided doses. As little as 1 gm/d for two days has elevated plasma carnitine levels. It appears that .3 to .5 gm/d of carnitine is enough to enhance plasma carnitine levels in normal subjects. Carnitine is best absorbed when taken without food upon arising & mid afternoon. Higher doses at one time may be overstimulating or cause nausea. Higher doses may rarely cause "fishy" breath or body odor.

How do you measure carnitine? Ninety eight percent of body carnitine is found in muscle tissue. There is no correlation between RBC, plasma & muscle carnitine levels. A muscle biopsy may be needed to detect muscle carnitine deficiency Nevertheless blood levels can be tested. A deficiency is indicted by plasma Free Carnitine (FC) levels less than 20 micro moles/liter. The test is also reported as the Total Carnitine minus the Free Carnitine divided by the Free Carnitine as TC-FC/FC. Any ratio number greater than 0.4 indicates a deficiency.

This newsletter is presented to make clear the existance and instances of special needs for carnitine. The presentation is a fraction of the studies available on the subject and hopefully will whet your appetite.

Please send me ideas on what you would like to see in future newsletters.

Until Next Time

BLESSINGS AND HEALTH,

PRISCILLA SLAGLE M.D.

AND REMEMBER:

The Buddha reportedly said for us to rise up and be thankful, for if we didn't learn a lot today, at least we learned a little, and if we didn't learn a little, at least we didn't get sick, and if we got sick, at least we didn't die; so, let us all be thankful in all things.

Hypertension is the term used to describe high blood pressure. High blood pressure can affect all types of people. Smoking, obesity, and diabetes are all risk factors.

High blood pressure is often known as the "silent killer," as it often does not cause symptoms, or the symptoms may not be recognized for what they are.

High Blood Pressure Symptoms can be:

Dizziness

Headaches

Blurred vision or other changes in vision

Chest pain

Shortness of breath

Confusion

Ear noise or buzzing

Irregular heartbeat

Nosebleed

Tiredness

Nausea and vomiting

Many factors can affect blood pressure, including:

How much water and salt you have in your body

The condition of your kidneys, nervous system, or blood vessels

The levels of different body hormones

Medications you may be taking

Excess caffeine intake

Stress

Activity level

Often no cause is identified. This is called essential hypertension.

High blood pressure that results from a specific condition, habit, or medication is called secondary hypertension. Numerous medical conditions can have high blood pressure as a component of the symptoms.

If you have any kind of blood pressure problem it is an excellent idea to have your own blood pressure cuff, learn how to use it properly and keep notes on your blood pressure readings so you can see what helps and what is aggravating. Giving this attention provides better overall control. Sometimes when you are on blood pressure meds, the pressure actually goes too low and may give unpleasant side effects at times of the day. The blood pressure feedback helps you help your Dr with the overall regulation. I usually suggest that for the first 1-2 weeks you check your pressure upon arising in the am and at night. Once you see which time tends to be your highest time use that time for your daily check and notes. If at any time you have symptoms of high or low blood pressure, also take a blood pressure reading. Take all of these notes to your appointment with your Dr, as this will be helpful. A good do it yourself blood pressure monitor is LifeSource UA-787 digital monitor.

Low Blood Pressure

Low blood pressure, or hypotension, occurs when blood pressure during and after each heartbeat is much lower than usual. This means the heart, brain, and other parts of the body do not get enough blood. Some of the symptoms of low and high blood pressure are the same. For low blood pressure there can be:

Light-headness

Fainting

Blurred vision

Inability to concentrate

Cold, clammy, pale skin

Nausea

Thirst

Fatigue

Sleepiness

Weakness

Low blood pressure is commonly caused by drugs such as:

Alcohol

Anti-anxiety medications

Certain antidepressants

Diuretics

Heart medicines, including those used to treat high blood pressure and coronary heart disease

Medications used for surgery

Painkillers

Other more common and less severe causes of low blood pressure include:

Dehydration

Adrenal fatigue

Changes in heart rate

Some more severe medical conditions may also lead to low blood pressure.

Q&A: What are some other healthy sources of calcium besides dairy products?

The best sources of calcium, in this case, would likely be dark leafy greens. Kale, chard, mustard greens, collards, and the like are all excellent sources of calcium.

With cold & Flu season approaching, it’s time to think of immune system supports. A useful & tasty product for children is chewable colostrum tablets. Of course adults can use it as well. In fact it tastes so good I look forward to my daily two doses.

Colostrum is the pre-milk fluid secreted by all mammals after giving birth. It acts to transfer valuable immune factors from the mother to the newborn to establish immune defenses. This is why Colostrum is known as nature’s first food for the immune system.

Symbiotics uses the finest bovine Colostrum. Studies have shown that bovine colostrum is very effective in humans and actually contains much more of the needed immune factors than are in human colostrums.

Symbiotics Colostrum Plus was created torestore and enhance the powerful immune factors and natural antibodies needed to protect the body from viruses, microorganisms, bacteria, allergens, pollutants and other toxic compounds.

Both adults and children encounter environmental and physical stress exposures daily. This daily stress when added to our “on-the-go” diet, takes it’s toll on the immune system. This is why your family may benefit from Colostrum Plus.

Additional causes for immune defense system depletion in adults & children include:

Age

Illness

Repeated infections

Taking antibiotics ( because they kill both good and bad bacteria)

Imbalance in normal flora of the gut

Yeast Infections (worsening yeast infection can lead to inflammation, Maldigestion, and Malabsorption).

Extensive medical research shows that Colostrum along with supporting the immune system alsohelps:

Protect and repair gastrointestinal damage

Balance blood sugar levels

Burn fat for fuel while building lean muscle

Increase strength and stamina

Add back antibodies and immune factors for dual action in the bloodstream and also in the GI tract

Toss ingredients in a bowl, drizzle dressing on top, and you're good to go!

About Dr. Slagle

Priscilla Slagle, M.D. is in the private practice of Nutritional and Functional Medicine & Psychiatry in Palm Springs, California.

Dr. Slagle has incorporated vitamins, minerals, amino acids, herbs, natural hormones & other natural substances into her practice since 1975. She is one of the pioneers in the Alternative Medicine Field.

Her book "The Way Up From Down" presents her natural "precursor" methods for lifting low moods & relieving the negative effects of stress.